Flat feet, the lack of a medial arch, may be a familial condition or may reflect joint laxity. Flat feet are insignificant if the foot is pain free, mobile and develops an arch when the patient stands on tiptoe.
Occasional underlying causes of flat feet include neurological problems such as poliomyelitis and muscular dystrophies and pathological joint laxity. Sometimes severe convex flat feet may due to congenital vertical talus. The latter condition necessitates early surgical intervention in order to avoid crippling deformity in later life. Flat feet may also be caused by tendon rupture or joint erosion, eg, as in rheumatoid arthritis. Factors associated with flat feet include genu valgum, torsional deformities of the tibia, and valgus deformities of the heel.
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